非酒精性脂肪性肝病患者血清瘦素和脂联素与胰岛素抵抗的关系

目的 探讨非酒精性脂肪性肝病(NAFLD)患者血清瘦素、脂联素的变化及其与胰岛素抵抗的关系. 方法 选取NAFLD患者60例,同期门诊体检健康者60名为对照组,ELJSA法测定血清瘦素、脂联素水平,并检测体质量指数、腰臀比、甘油三酯、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、空腹血糖、ALT、AST、γ-谷氨酰转肽酶(GGT),稳态模型评估的胰岛素抵抗指数(HOMA-IR).采用SPSS10.0软件包进行统计学分析,计量资料差异性比较用方差分析和t检验,多因素相关性用Spearman分析和Logistic回归分析. 结果 血清瘦素、脂联素水平NAFLD组分别为(12.37±1.99)μg/L和(12.69±2.83)mg/L,对照组分别为(5.20±1.03)μg/L和(22.83±4.61)mg/L,t值分别为24.661和14.516,P值均<0.01;HOMA-IR,NAFLD组为4.86±0.63,对照组为1.91±0.41,t值为30.451,P<0.01.Logistic多因素回归分析显示瘦素与腰臀围之比、HOMA-IR、空腹血糖呈独立正相关,β值分别为8.175、0.974和0.564,P值均<0.01;脂联素与HOMA-IR、体质量指数呈独立负相关,β值分别为-0.495和-0.314,P值均<0.01.结论 NAFLD患者血清瘦素、脂联素的变化与胰岛素抵抗有关.

The relationship of leptin and adiponectin with insulin resistance in nonalcoholic fatty liver disease

Objective To investigate the serum leptin and adiponectin levels in nonalcoholic fatty liver disease (NAFLD) patients, and their relationship with insulin resistance. Methods A total of 120 cases were enrolled and divided into two groups: NAFLD group (n = 60) and normal control group (n = 60). The serum levels of leptin and adiponectin were measured by EL1SA. The body mass index (BMI), waist-to-hip ratio (WHR), triglyceride (TG), total cholesterol (Tchol), high-density lipoprotein cholesterol (HDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), fasting blood glucose (FBG) and HOMA-IR (homeostasis model assessment insulin resistance) were detected and analyzed. Results Compared with control group, the serum leptin level in NAFLD group was Significantly higher [(12.37 ± 1.99) μg/Lvs (5.20 ± 1.03)μg/L,P<0.01], while the serum adiponectin level was significantly lower [(12.69 ± 2.83) mg/L vs (22.83 ± 4.61) mg/L, P < 0.01]. HOMA-IR was also much higher in NAFLD group than that in control group[(4.86 ± 0.63) vs (1.91 ± 0.41), P < 0.01]. Logistic regression analysis showed that leptin was positively correlated with WHR ( P = 8.175, P < 0.01), HOMA-IR ( P = 0.974, P < 0.01 ), FBG ( β = 0.564, P < 0.01). In contrast, adiponectin inversely associated with HOMA-IR ( β = -0.495, P < 0.01 ) and BMI ( β = -0.314, P < 0.01) respectively. Conclusions The increased serum leptin level and decreased serum adiponectin level in NAFLD patients independently associated with HOMA-IR.